| NPI | 1497153332 |
|---|---|
| Former Name | MAURICIO ALEJANDRO VILLAVICENCIO THEODULOZ |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MN 1015) |
| Additional Taxonomies | 204F00000X Transplant Surgery (Licence: MA 264532) |
| 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MA 264532) | |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2025-06-12 |